Honestly “modern healthcare” was pushing it for a lot of them even when they were open, due to decades of cuts and lack of investment. The (now closed) hospital that was in the rural community I grew up in had a reputation for being a place you went if you had no other choice, or it was a very minor emergency even they couldn’t fuck up. My parents floored it to the nearest city (40 minute drive) every time my mom went into labor, despite the local hospital being maybe 15 minutes away max if you drove the speed limit.
You can’t read text and view a person’s expression at the same time, but you can watch signing and see the expression (sometimes because it’s part of the sign itself).
For some Deaf people it’s also an issue that they aren’t as fluent in written English as they are in American Sign Language. Text isn’t going to help them if they can’t figure out what it means, or it’s going by too fast to comprehend.